Mayo Clinic unveils plans for sophisticated cancer treatment

by Ken Alltucker - Nov. 17, 2010 12:00 AMThe Arizona Republic

Mayo Clinic's new $182 million radiation-therapy center will introduce a sophisticated cancer-fighting method to Phoenix, offering pinpoint radiation that can bring improved results with less tissue damage.

Mayo joins a small but growing collection of health-care providers nationwide that are investing hundreds of millions of dollars in a technology called proton-beam therapy. The radiation method employs the use of towering three-story machines that deliver tumor-attacking protons.

Advocates of proton-beam therapy say it offers more-targeted and higher doses of radiation to tumors and causes less damage to healthy tissue than conventional X-ray radiation treatment. Critics, however, say it is pricey and does not always provide a significant upgrade over other treatment options.

Mayo Clinic studied the possibility of bringing proton-beam therapy to Arizona and its Rochester, Minn., headquarters for about six years. Executives concluded that the potential benefits to children and adults with specific cancers, and demand for the therapy, would justify the estimated $370 million price tag for the dual facilities.

"This is a form of upping the ante for cancer treatment," said Dr. Victor Trastek, vice president and chief executive officer of Mayo Clinic in Arizona. "More and better care is showing up for people who live here."

Mayo Clinic's announcement Tuesday of plans for the new radiation-therapy center is the latest effort among numerous Phoenix-area health-care providers to offer advanced cancer-treatment options to Arizonans.

Banner Health is teaming with the University of Texas-MD Anderson Cancer Center to open a $90 million center on the campus of Banner Gateway Medical Center in Gilbert. The Arizona Cancer Center, part of the University of Arizona, plans to open an outpatient center in the Phoenix area. The for-profit Cancer Treatment Centers of America has a hospital in Goodyear, and other regional hospitals, such as St. Joseph's Hospital and Medical Center in Phoenix, Scottsdale Healthcare and others, have expanded cancer treatments.

Mayo Clinic's plans call for constructing a 100,000-square-foot building to house the proton therapy equipment needed for four treatment rooms. The equipment includes a cyclotron and a mammoth 100-ton, three-story motorized machine called a gantry.

The machines generate and deliver protons that attack tumors in similar ways to conventional X-ray therapy. But the proton method is less likely than X-ray radiation to destroy healthy tissue.

Mayo Clinic said its proton facilities will be outfitted with a cutting-edge type of proton therapy, called pencil-beam scanning, that it says is more precise. MD Anderson also offers pencil-beam scanning in Houston, but it has no plans to bring the technology to its Gilbert center.

More than a half-dozen centers in the United States now offer proton therapy, including pioneers Massachusetts General Hospital and Loma Linda Medical Center in Southern California. There are plans to build several more centers across the nation, from Washington state to Florida.

Dr. Andrew Lee, medical director of MD Anderson's proton-therapy center in Houston, said he sees more treatment opportunities with all the growth and does not view Mayo as a competitor.

"Given the number of proton centers, we have to work together to advance the field," Lee said. "The enemy is still cancer."

Mayo Clinic estimates it will treat about 1,200 patients each year after its Arizona proton center opens in late 2014 or early 2015. Mayo anticipates the center will employ about 130 staff members, including 13 physicians and nine physicists. Arizona State University is expected to provide a pipeline of physicists who work at the new proton-beam therapy center.

Dr. Michael Etzl, director of Phoenix Children's Hospital's center for cancer and blood disorders, said, "The biggest impact potentially could be in pediatrics."

Etzl said the technology could be especially useful for children with complicated tumors in the brain or near the spine.

Children who receive conventional radiation therapy face some risk of developing secondary tumors. Conventional radiation therapy also can harm a child's cognitive development.

In addition to treating pediatric cancers, Mayo Clinic said the technology may be useful to attack tumors of the breast, in or near the eye, and gastrointestinal, head and neck, lung, spine and prostate cancers.

Some who have studied the use of proton-beam therapy question whether the therapy is always worth its cost.

A 2007 study from the Journal of Clinical Oncology compared proton-beam therapy to a more common form of radiation therapy on prostate-cancer patients. For a 70-year-old man, the proton-therapy treatment cost $63,511, compared with $36,808 for the more common radiation therapy.

The benefit of using proton therapy on prostate-cancer patients was marginal when compared to the cost of the technology, the study concluded.

"Consideration should be given to limiting the number of proton facilities to allow comprehensive evaluation of this modality," the article's authors wrote.

Hayes Inc., a Philadelphia-area health-care consultant, also has extensively studied the growing use of proton therapy. The consultant concluded that proton therapy has real benefits for treating eye, head and neck and spinal cancers. But Hayes' research said that proton therapy is among the most expensive medical technologies, with costs as much as three times as expensive as X-rays. What's more, Hayes said that proton therapy has not proven that it's a better option than conventional treatments when cost and health outcomes are factored.

Jerry Ferguson, 76, of Sun City, is among those who swear by the emerging technology.

Ferguson was diagnosed with prostate cancer in 2003.

Ferguson and his wife rented an apartment in Southern California as he underwent 40 proton-therapy sessions at Loma Linda University Medical Center. He said the sessions were quick and painless. The treatment was paid by Medicare and his supplemental insurance.

Today, he has recovered, with no signs of cancer.

"My quality of life has not changed," Ferguson said. "I lead a normal life, and I have come out withou